1 Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA 2 Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA.
Patient. 2008 Jan 1;1(1):41-54. doi: 10.2165/01312067-200801010-00007.
To assess associations between race/ethnicity and medication adherence, and the potential modifying effects of weight category (normal, overweight, obese) in a community-based sample.
We studied 1355 participants from the CARDIA (Coronary Artery Risk Development in Young Adults) study who were taking prescription medications in 2000-1. Medication adherence, as rated on the four-item Morisky medication adherence scale (score of 4 = maximum adherence), was reported for all participants.
The mean age ± SD of participants was 40 ± 3.6 years; 45% were African American and 36% were male. Overall, Whites had a higher proportion of maximum adherence than African Americans (59 vs 41%, respectively; p = 0.001). However, this difference was statistically significant only for participants within the normal weight category, of whom 54% of Whites were maximally adherent versus 35% of African Americans (p < 0.05). After adjustment for possible confounding covariates, race/ethnicity was associated with adherence only in those of normal weight: the odds ratio for maximum adherence in Whites versus African Americans of normal weight was 1.98 (95% CI 1.13, 3.47). Within race/ethnicity subgroups, weight category was associated with adherence in Whites but not in African Americans.
Weight category modifies the association of race/ethnicity with medication adherence. The high levels of non-adherence observed among African Americans and obese and overweight Whites bodes poorly for treatment of obesity-associated diseases such as cardiovascular disease or diabetes mellitus.
在社区样本中评估种族/民族与药物依从性之间的关联，以及体重类别（正常、超重、肥胖）的潜在调节作用。
我们研究了 1355 名来自 CARDIA（年轻人冠状动脉风险发展）研究的参与者，他们在 2000-1 年期间服用处方药。所有参与者都报告了四项目莫斯基药物依从性量表（得分 4=最大依从性）的药物依从性。
参与者的平均年龄±标准差为 40±3.6 岁；45%为非裔美国人，36%为男性。总体而言，白人比非裔美国人有更高比例的最大依从性（分别为 59%和 41%；p=0.001）。然而，这种差异仅在正常体重类别内的参与者中具有统计学意义，其中 54%的白人是最大依从者，而非裔美国人的比例为 35%（p<0.05）。在调整了可能的混杂协变量后，种族/民族仅与正常体重者的依从性相关：正常体重的白人与非裔美国人最大依从性的比值比为 1.98（95%CI 1.13，3.47）。在种族/民族亚组内，体重类别与白人的依从性相关，但与非裔美国人无关。
体重类别调节了种族/民族与药物依从性之间的关联。非裔美国人和肥胖及超重白人中观察到的高不依从率预示着肥胖相关疾病（如心血管疾病或糖尿病）的治疗效果不佳。
